title: Critical involvement of the motor cortex in the pathophysiology and treatment of Parkinson's disease.
abstract: This review examines the involvement of the motor cortex in Parkinson's disease (PD), a debilitating movement disorder typified by degeneration of dopamine cells of the substantia nigra. While much of PD research has focused on the caudate/putamen, many aspects of motor cortex function are abnormal in PD patients and in animal models of PD, implicating motor cortex involvement in disease symptoms and their treatment. Herein, we discuss several lines of evidence to support this hypothesis. Dopamine depletion alters regional metabolism in the motor cortex and also reduces interneuron activity, causing a breakdown in intracortical inhibition. This leads to functional reorganization of motor maps and excessive corticostriatal synchrony when movement is initiated. Recent work suggests that electrical stimulation of the motor cortex provides a clinical benefit for PD patients. Based on extant research, we identify a number of unanswered questions regarding the motor cortex in PD and argue that a better understanding of the contribution of the motor cortex to PD symptoms will facilitate the development of novel therapeutic approaches.
authors.affiliation: Behavioral Neuroscience Program, Department of Psychology, Binghamton University - State University of New York, PO Box 6000, Binghamton, NY 13902-6000, USA. Electronic address: dlinden1@binghamton.edu.
authors.forename: David
authors.initials: D
authors.lastname: Lindenbach
authors.forename: Christopher
authors.initials: C
authors.lastname: Bishop
mesh_terms: D046690:Deep Brain Stimulation; D004298:Dopamine / Q000378:metabolism; D006801:Humans; D009044:Motor Cortex / Q000378:metabolism / Q000502:physiology* / Q000503:physiopathology*; D010300:Parkinson Disease / Q000473:pathology* / Q000628:therapy*
chemical_list: D004298:Dopamine
keywords: Deep brain stimulation; Dopamine; Functional imaging; Motor cortex; Parkinson's disease; Plasticity; Premotor cortex; Supplementary motor area; Transcranial magnetic stimulation